General Health

How do ICD codes help in improving the healthcare sector?

ICD, formally called as International Statistical Classification of Diseases and Related Health Problems or simply International Classification of Diseases, comprises all the diseases, disorders and injuries. The ICD, developed and updated by the World Health Organisation (WHO) is a diagnostic tool that is used by healthcare professionals, paramedic staff, insurance companies, researchers and policymakers all over the world for clinical, administrative and research purposes. The list contains standardised medical protocols for recording and tracking the data of many diagnosed diseases. This allows for conducting research, understanding the causes of the disease and formulating appropriate treatments. 

Some of the uses of ICD are as follows: 

  • Tracking the occurrences of the diseases 
  • Finding out and collating the causes of death
  • Explains external factors that trigger an illness
  • Incorporating primary care and family medicine concepts 
  • Documenting patient safety, in line with the WHO patient safety framework
  • Dual coding for traditional medicine diagnoses
  • Recording of rare diseases
  • Casemix or Diagnosis Related Groupings (DRG), resource allocation
  • Embedding of guidelines

The currently used version is ICD-10 which came into effect after 1992. ICD-10 has around 55,000 more codes for the more recent diseases and newer protocols as compared to the previous ICD-9. Some of the modified forms of ICD-10 are ICD-10-CM (clinical modifications) which includes diagnosis codes and ICD-10-PCS (Procedure coding system) which includes protocol codes. 

ICD-10 has helped to understand and improve the medical sector in countless ways. ICD-10 specifically includes health insurance schemes, thereby promoting rational and affordable payment options. It helps to improve health care costs, ensuring fair reimbursement policies. The up-to-date codes specifically help healthcare providers to identify patients who are in urgent need of treatment and diagnostic measures, promoting better health policies. ICD-10-CM includes more public health conditions, such as external injuries due to military training and terrorist attacks, which were not specified in the previous ICD-9-CM version. The coding system of ICD-10, unlike its previous version, has minimal errors and can be easily configured into an electronic format making it more efficient and accessible. Lastly, the ICD-10 reduces medication error, offers better treatment options and reduces disease outcomes.  

ICD-11 was presented at the 72nd World Health Assembly in May 2019 and will come into effect on January 1st 2022. ICD-11 coding system is more refined than ICD-10 and will have extra codes on the following conditions:

  • Mental health disorders such as Gaming disorder, Prolonged Grief Disorder, Complex Post Traumatic Stress Disorder, Catatonia, Olfactory Reference Disorder
  • Identifying Burn-out as a lifestyle disorder
  • Compulsive sexual behaviour disorder,  hypoactive sexual desire dysfunction and paraphilic disorders (intense atypical sexual desire) in behavioural sexual disorders 
  • Extra information on transgenderism and gender dysphoria
  • Antimicrobial resistance and codes in line with WHO’s Global Antimicrobial Resistance Surveillance System to understand the immunity of several microbes against medication
  • Allergies as immune system-related conditions 
  • Stroke as a cardiovascular disorder
  • Practising family care and traditional medicine 
  • Sleep disorders 

ICD-10 has been adopted globally and it has helped the healthcare system in India as well. Many doctors have found the coding system easy to use and access without the need of other technical professionals. The pharmacists have to learn the coding system from medical representatives as well as be encouraged to reduce the use of unspecified codes for medication. ICD also benefits the pharmaceutical industry by reducing the number of payment errors to providers while purchasing the medicines and medical equipment required for various procedures. It also incorporates better data storage programs and profitable pricing strategies. 

As of January 2021, WHO has updated the ICD-10 for COVID-19 which includes 

  1. The diagnosis and detection of both symptomatic and asymptomatic forms of the infection
  2. The deaths caused due to the infection
  3. Personal history of Covid-19 
  4. Post COVID-19 associated issues 
  5. Multisystem inflammatory syndrome associated with COVID-19 
  6. Immunization to prevent COVID-19 
  7. Adverse effects of COVID-19 

The unpredictable and increasingly rapid nature of the pandemic has put a huge strain on the healthcare system, in terms of morbidity, disease management, infrastructure, availability of resources and insurance policies. Implementing ICD offers a more systematic approach to handle all the issues arising in the field of medicine, thereby formulating better solutions to deal with such unusual circumstances.

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